Congressman Cartwright offers reality check on Affordable Care Act

For a decade, said Ford, health insurance premiums were rising five times faster than wages. “The health care law is never going to get premiums back down to where they were in the 90s, but what it can do is slow that increase and that’s what a lot of Americans really need.”

Cartwright said the new law allows parents to keep children on their policies until they are 26 years old. It gives small businesses better purchasing power when they go to buy health insurance plans for their employees, “with new tax credits to ease the burden of providing employees with health coverage.”

Ford said insurance companies no longer will be able to charge people more if they have a pre-existing health condition, such as if they have had a heart attack.

They also no longer can charge women more than men. And they can only charge their oldest policy holders three times as much as they charge their youngest, healthiest policy holders.

“They can still charge you more for smoking,” said Ford, suggesting that gives people another reason to make a New Year’s resolution to quit.

Palmquist said AARP did not get everything it wanted in the new health care law, but supports it because a “tremendous” number of 50-65-year-olds don’t have any health coverage.

Ford said insurance companies now can take away medical coverage only “if they can prove you were trying to commit fraud” – not because you get sick and start costing them money. She said lifetime limits on insurance policies also are going away. She said insurance companies even must give money back to people if they start charging more than needed for care.

Cartwright recommended when pricing policies, “don’t just take the word of one insurance company -- typically your own insurance company -- that writes you a letter. Wait to see what else is available. See what other companies have to offer. What we’re up to here is we’re spurring competition among insurance companies. That’s one of the big picture goals of this law.”

Cartwright said the law improves Medicare’s prescription drug coverage for seniors by gradually closing the Medicare Part D “doughnut hole” until it no longer exists by 2020.

Ford explained that “doughnut hole” requires seniors to pay thousands of dollars for prescription drugs. She said “that’s where we hear the horror stories of seniors ripping pills in half and choosing between food and medicine.

“If you’re a low income senior, you won’t have to sell your house before you can get help paying for your prescription drugs.”

Ford said the law also gives money to states so low-income workers can go into Medicaid. “Pennsylvania hasn’t accepted those funds yet. All the states surrounding us have. In Pennsylvania, about 400,000 people won’t be eligible for coverage come Jan.1.”

“I regret that position on the part of the governor,” said Cartwright. “I oppose that position. I think it’s the wrong thing to do. This is basically Pennsylvania turning its back on federal assistance to get these folks insured. A big part of me thinks he’s only doing that to make a political point, to stick the President in the eye.”

The audience applauded.

Young invincibles

Ford said most Americans must have health insurance beginning next year. Those who do not sign up next year must pay a penalty of $95 or one percent of their income, whichever is higher. She said in 2015 that increases to $325 or two percent of income. In 2016, it is more than $600 or 2.5 of income.

“The idea behind these penalties is to get people to sign up for health care,” said Cartwright. “What we’re after are what they call the young invincibles, the young people who are never going to get sick.

“Please encourage them to get the insurance. They will be amazed at how cheap it is. Yeah, they’re young and healthy. But they’re also the most likely to have catastrophic accidents.

“We need to get them signed up for a couple of reasons. We need their premium dollars to help support the whole system. If all we get are older, sicker people to sign up, it’s not going to work. At some point we’ve got to stop being the me generation and pull together and share the sacrifice.

“But even more than that, you’re only young and healthy until you’re not. That’s been the biggest burden on our health care system.

“Hospitals absorb the uninsured care, over and over. If you show up in an emergency room, they pretty much have to treat you. And people know that. But eventually hospitals can’t absorb any more. They stop circling the drain and they go down it.

“One of the reasons I’ve supported this law is it strengthens our hospitals. In the 17th Congressional District, we lost two community hospitals in the last two years. Instead of a five-minute ride to the hospital, it’s a 25-minute ride and that can be the difference between life and death in certain circumstances.”

He later said those hospitals were St. Catherine’s in Ashland, Schuylkill County and. Marian Community Hospital in Carbondale, Lackawanna County.

Myths

Cartwright confirmed that the vast majority of Americans are not losing their health insurance coverage because of the new law and agreed that fact is not being covered by the media. He said only four or five percent of Americans are being dropped by their insurance companies. “It doesn’t mean they’re not important and we shouldn’t address that.”

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